Here we report the first Korean case of a girl who developed noninvasive squamous cell carcinoma of the vulva at the age of 16 years. She was taking tacrolimus, an immunosuppressive agent, after living-related liver transplantation. The vulvar masses were microscopically proved as vulvar intraepithelial neoplasm II and III, even squamous cell carcinoma in situ. Human papillomavirus subtypes (69 and 73) and human papillomavirus types (66, 70, 73, and 43) were detected in the vulvar mass and the cervicovaginal smear, respectively. The outcome of liver transplantation for children has been markedly improved during the last several decades. However, the present case highlights the need to perform periodic genital examinations for the adolescents after liver transplantation. In addition to the high risk and probable high subtypes, uncommonly found human papillomavirus subtypes were extracted from her vulvar cancer. The present case is the first to show the possible relationship between previously unknown and uncommon human papillomavirus subtypes and pediatric post-transplant vulvar squamous cell carcinoma. More attention should be paid to the vulvar and cervical surveillance of pediatric transplant recipients by both medical specialists and general physicians.
Adolescent ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Child ; Humans ; Liver ; Liver Transplantation ; Specialization ; Tacrolimus ; Vulva ; Vulvar Neoplasms

Sclerosing stromal tumor (SST) was first delineated as a distinct ovarian sex cord stromal tumor in 1973 by Chalvardjian and Scully. It is a benign neoplasm, distinguished from other ovarian stromal tumors by the production of collagen and a pseudolobular pattern, and it tends to occur in the second and third decades of life in diagnosed patients. We discovered two rare cases of SST in post-menopausal women which are the topic of this report. These case studies are accompanied by a brief review of the literature.
Collagen ; Female ; Humans ; Menopause ; Ovarian Neoplasms ; Ovary* ; Sex Cord-Gonadal Stromal Tumors

No abstract available.
Uterine Cervical Neoplasms*

Lung cancer is a malignant tumor that is often fatal. Vaginal metastasis of pulmonary adenocarcinoma is very rare. To the best of our knowledge, this is the second such report worldwide and the first one from Korea. A 67-year-old woman presented with cough, excessive sputum and dyspnea that she had sufferd with for the past one year and she had a palpable lesion in the vagina. Chest CT showed diffuse bronchial wall thickening involving the left main bronchus, the left upper lobar bronchus and the lingular divisional bronchus of the left upper lobe. There were multiple, various sized nodules in both lungs, of which the largest one measured about 1.0 cm in diameter. Both lung and vaginal biopsies were performed and the masses were diagnosed as adenocarcinoma. Immunohistochemically, the tumor cells were positive for cytokeratin 7 and TTF-1, but they were negative for cytokeratin 20. We present this case of primary lung adenocarcinoma metastasis to the vagina.
Adenocarcinoma ; Aged ; Biopsy ; Bronchi ; Cough ; Dyspnea ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Korea ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Sputum ; Thorax ; Vagina

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.
Douglas' Pouch ; Endometriosis* ; Female ; Lymph Nodes ; Metaplasia ; Neoplasm Metastasis ; Ovary ; Peritoneum ; Stem Cells ; Teratoma*

OBJECTIVE: To evaluate correlation of preoperative anemia with clinical outcomes in patients with early stage cervical cancer who were treated with radical hysterectomy and lymph node dissection. METHODS: Patients who underwent radical hysterectomy and lymph node dissection for cervical cancer from January 2001 to February 2012 were included in this study. Clinicopatholgoical factors included in univariate and multivariate analysis were age, tumor histology, FIGO (International Federation of Gyneocology and Obstetrics) stage, preoperative hemoglobin, depth of invasion, tumor size, parametrial involvement, resection margin, and lymph node status. RESULTS: A total of 387 patients were retrospectively analyzed in this study; 141 patients (36.4%) had preoperative anemia (hemoglobin <12 g/dL) and 16 out of 141 patients (11.3%) received blood transfusion for correction of preoperative anemia. Patients with preoperative anemia showed significant association with age <50 years, more advanced stage, non-squamous cell carcinoma histology, larger tumor size, deeper stromal invasion, and lymph node metastasis (P<0.05). Both relapse-free survival and overall survival were worse in patients with preoperative anemia in univariate analysis. In multivariate analysis, overall survival was worse in patients with preoperative anemia, but relapse-free survival was not associated with preoperative anemia. In the intergroup analysis of anemic patients for the effect of preoperative blood transfusion, preoperative anemia correction did not affect survival. CONCLUSION: Preoperative anemia was not an independent prognostic factor for survival in patients with early cervical cancer. However, it was associated with poor prognostic factors. Further study in large population is needed.
Anemia* ; Blood Transfusion ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Uterine Cervical Neoplasms*

Placenta accreta during the first trimester of pregnancy is rare. Only a few cases of placenta accreta manifesting as a uterine mass have been published. Most patients with placenta accreta present with vaginal bleeding during or after pregnancy. This report describes a patient with placenta accreta that caused vaginal bleeding three years after a first trimester abortion. The patient had regular menstruation for three years after the abortion. Initially endometrial cancer or a uterine myoma with degeneration was suspected. This is the first report of a placenta accreta detected as a uterine mass long after a first trimester abortion with delayed vaginal bleeding.
Endometrial Neoplasms ; Female ; Humans ; Menstruation ; Myoma ; Placenta Accreta ; Placenta, Retained ; Pregnancy ; Pregnancy Trimester, First ; Uterine Hemorrhage ; Uterine Neoplasms

Sertoli-Leydig tumors tend to relapse early and due to their rarity, limited data are available regarding a role of chemotherapy in the management of Sertoli-Leydig cell tumors. We present a case of recurrent ovarian Sertoli-Leydig cell tumor whose salvage treatment was successful with paclitaxel and carboplatin chemotherapy.
Carboplatin ; Female ; Ovary ; Paclitaxel ; Recurrence ; Salvage Therapy ; Sertoli-Leydig Cell Tumor

In this article, on page 115, the title has been spelled incorrectly in this article.

This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*mortality/*secondary/therapy ; Chemoradiotherapy ; Female ; Genital Neoplasms, Female/*mortality/pathology/therapy ; Humans ; Middle Aged ; Multivariate Analysis ; Ovarian Neoplasms/mortality/pathology/therapy ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms/mortality/pathology/therapy ; Uterine Neoplasms/mortality/pathology/therapy ; Young Adult